AUTHOR=Kang Kaijiang , Wang Yu , Wu Jianwei , Wang Anxin , Zhang Jia , Xu Jie , Ju Yi , Zhao Xingquan 

TITLE=Association Between Cumulative Exposure to Increased Low-Density Lipoprotein Cholesterol and the Prevalence of Asymptomatic Intracranial Atherosclerotic Stenosis

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.555274

DOI=10.3389/fneur.2020.555274

ISSN=1664-2295

ABSTRACT=<p><bold>Background and Purpose:</bold> Intracranial atherosclerosis has gained increasing attention due to the high risk of recurrent clinical or subclinical ischemic events, while the relationship between low-density lipoprotein cholesterol (LDL-C) measured at a single time point and intracranial atherosclerotic stenosis (ICAS) is inconsistent. This study aims to assess the association between cumulative exposure to increased LDL-C and the prevalence of asymptomatic ICAS.</p><p><bold>Methods:</bold> The Asymptomatic Polyvascular Abnormalities Community study was investigated on the epidemiology of asymptomatic polyvascular abnormalities in Chinese adults. In this study, we included 4,523 participants with LDL-C measured at 3 examinations in 2006, 2008, and 2010. Cumulative exposure to increased LDL-C was calculated as following: LDL-C burden<sub>2006−2008</sub> = [(LDL-C<sub>2006</sub>-1.8) + (LDL-C<sub>2008</sub>-1.8)]/2 <sup>*</sup> time<sub>2006−2008</sub>; LDL-C burden = LDL-C burden<sub>2006−2008</sub> + LDL-C burden<sub>2008−2010</sub>. Transcranial doppler ultrasonography was performed in 2010 to detecting the ICAS.</p><p><bold>Results:</bold> Of the 4,347 patients, 13.3% (580/4,347) were diagnosed with ICAS. In univariate analysis, the association between LDL-C burden and ICAS prevalence was significant, the odds ratios (95% confidence interval) from the lowest to the highest quartile were 1 (reference), 1.30 (0.99–1.70), 1.32 (1.01–1.73), and 2.14 (1.66–2.75), respectively (<italic>P</italic> &lt; 0.05). After adjustment for potential confounding factors, the same result was reached.</p><p><bold>Conclusions:</bold> Cumulative exposure to increased LDL-C is concentration-dependently associated with increased prevalence of asymptomatic ICAS, especially in those under the age of 65 y or free of hypertension, diabetes mellitus, and hyperlipidemia.</p>